SARS (Severe Acute Respiratory Syndrome) in China

CDC Health Update

Distributed via Health Alert Network
December 29, 2003, 15:35 EST (03:35 PM EST)
CDCHAN-00176-03-12-29-UPD-N

Suspected SARS in Guangdong Province, China 
December 2003

On December 26, 2003, the Chinese Ministry of Health (MOH) reported a single case of suspected severe acute respiratory syndrome (SARS) in a 32-year-old man in the southern Chinese province of Guangdong.  Two notices describing the Chinese MOH report are available on the Web site of the World Health Organization (WHO) Regional Office for the Western Pacific www.wpro.who.int/sars/ (the text of the update posted on December 29 and the initial announcement of December 27 is provided below).

According to the Web site, the patient developed a fever and headache on  December 16. On December 20, he sought medical assistance and was diagnosed with pneumonia on the basis of his symptoms and chest x-ray changes in the lower right lung. Laboratory testing carried out at three Chinese laboratories has indicated the possibility of infection with SARS coronavirus (SARS CoV), but the results are inconclusive.  WHO has advised that additional testing of specimens be conducted at laboratories outside of China for international verification of the results. 

The patient is reported to be in isolation in a Chinese hospital and in stable condition.  All relevant human contacts of the patient have been identified and tested and are doing well.  Preliminary epidemiologic investigations indicate that, in the 2 weeks prior to the onset of symptoms, the patient had no known contact with high-risk groups, such as health workers or animal handlers. The source of the suspected SARS coronavirus infection is therefore unclear at this stage.

The U.S. Centers for Disease Control and Prevention (CDC) is in close communication with the World Health Organization (WHO) about this case.  Additional information will be provided as more is learned about the situation. 

For more information about SARS, including CDC’s draft Public Health Guidance for Community-Level Preparedness and Response to Severe Acute Respiratory Syndrome (SARS), please see CDC’s Web site at www.cdc.gov/ncidod/sars/index.htm

Update on Suspected SARS Case in Southern China
29 December 2003

On Friday, December 26, the Ministry of Health of China informed the World Health Organization about a suspected case of severe acute respiratory syndrome (SARS) in a hospital in Guangzhou. At the present time the case remains classified as suspected SARS. Investigation will continue until the final diagnosis is established.

According to the Ministry of Health of China, all close contacts of the patient have been identified by public health authorities in Guangdong. All these individuals have been given the necessary advice and are at present well, the authorities say.

Regular daily meetings have been held between the Ministry of Health of China and WHO through its China office. Information on the clinical state of the individual, the laboratory investigation and the public health response is being shared.

The Ministry of Health and WHO are collaborating in the following areas:
A laboratory expert arrived in Beijing this morning (December 29), and a series of meetings have been arranged with the Ministry of Health and the Chinese Centers for Disease Control (CDC) to review the test results and discuss other technical issues.

A joint Ministry of Health / China CDC / WHO team is traveling to Guangdong to provide additional support to the investigation that is already under way. The three WHO experts, accompanied by a translator, have already left Beijing and are expected to arrive in Guangdong later this afternoon, when meetings with Provincial Authorities and local public health teams have been planned. They will provide technical support in the areas of epidemiological investigation and infection control.

WHO will facilitate the shipment of additional diagnostic materials.

Although the final diagnosis of this case is still awaited, WHO has been strongly assured that all appropriate steps have been taken by health authorities to ensure that any risk to the public health has been minimized.

Source: World Health Organization Western Pacific Region www.wpro.who.int/sars/

Suspected SARS Case in Southern China
 27 December 2003

Manila -- On Friday, December 26, the Chinese Ministry of Health (MOH) informed the World Health Organization office in Beijing of a suspected case of severe acute respiratory syndrome (SARS) in a hospital in Guangzhou city, Guangdong province. The MOH diagnosed the case as suspected SARS after reviews by a joint panel composed of experts from the MOH and Guangdong.

The patient, described as a 32-year-old television producer from Guangzhou, is in isolation in hospital. His condition is said to be stable, and his temperature has been normal for three days. According to information supplied to WHO by the Chinese Ministry of Health, the patient developed a fever and headache on 16 December. On 20 December, he sought medical assistance at Zhongshan University 1st Affiliated Hospital, and was diagnosed as having pneumonia. Chest x-rays showed changes in the lower right lung. He was placed in isolation that day for observation. On 24 December, the patient was transferred to the Guangzhou 8th People's Hospital.

Laboratory tests have been carried out by three laboratories: two under China's Centers for Disease Control (CDC) and the other with the Guangdong provincial CDC. The Ministry of Health has informed WHO that the results indicate the possibility of SARS CoV infection. However, results at this stage are inconclusive, and further tests need to be carried out for a final conclusion. WHO has suggested that samples be sent overseas for international verification of the results.

The Ministry of Health also reports that all relevant human contacts of the patient have been identified, tested, and are deemed to be doing well, although some remain in isolation, under observation.

The Ministry of Health has asked WHO to supply a laboratory expert to help with interpretation and verification of the results  of tests done so far and to assist with further investigations. This expert is expected to arrive in Beijing early next week. The Chinese health authorities have also asked for medical equipment, including test kits.

The Chinese Ministry of Health says epidemiological investigations show that in the two weeks prior to the onset of     symptoms the patient had no known contact with high-risk groups such as health workers or animal handlers. The source of the suspected SARS infection is therefore unclear at this stage.

For further information from Sunday 28 December, please contact Mr. Roy Wadia in Beijing on +86 1361 117 4072. For enquiries in Europe, please contact Mr. Dick Thompson on +4122 791 2684 or +4179 475 5475.

Source: World Health Organization Western Pacific Region http://www.wpro.who.int/sars/